Volumetric analysis of the liver after right portal vein embolization: mid-term follow-up based on embolization score

Shin, J.H.; Yoon, H.-K.; Kwon, J.; Lee, S.W.; Chae, E.Y.; Ko, G.-Y.; Sung, K.B.; Gwon, D.-I.

doi:10.1016/j.crad.2009.09.019

« Previous Next »Clinical Radiology
Volume 65, Issue 4 , Pages 288-296, April 2010

Volumetric analysis of the liver after right portal vein embolization: mid-term follow-up based on embolization score

J.H. Shin
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1, Pungnap-2dong, Songpa-gu, Seoul 138-736, Republic of Korea
- Guarantor and correspondent: J.H. Shin, Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1, Pungnap-2dong, Songpa-gu, Seoul 138-736, Republic of Korea. Tel.: +82 2 3010 4380; fax: +82 2 476 0090.
H.-K. Yoon
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1, Pungnap-2dong, Songpa-gu, Seoul 138-736, Republic of Korea
J. Kwon
- Department of Radiology, Dongkuk University Hospital, Ilsan, Republic of Korea
S.W. Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1, Pungnap-2dong, Songpa-gu, Seoul 138-736, Republic of Korea
E.Y. Chae
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1, Pungnap-2dong, Songpa-gu, Seoul 138-736, Republic of Korea
G.-Y. Ko
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1, Pungnap-2dong, Songpa-gu, Seoul 138-736, Republic of Korea
K.B. Sung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1, Pungnap-2dong, Songpa-gu, Seoul 138-736, Republic of Korea
D.-I. Gwon
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1, Pungnap-2dong, Songpa-gu, Seoul 138-736, Republic of Korea

Received 26 May 2009; received in revised form 24 September 2009; accepted 27 September 2009.

Aim

To evaluate liver volume alterations and liver function after right portal vein embolization (PVE) during mid-term follow-up based on embolization score.

Materials and methods

Computed tomography (CT) images and liver function profiles were obtained before PVE, and at short-term (7–45 days), and mid-term follow-up (106–380 days) after PVE in all 30 patients. The patients were divided into group A (PVE score ≥3, n=20) and group B (PVE score <3, n=10). High score indicates more complete embolization.

Results

Left liver volume (LLV) and percentage future liver remnant (%FLR) increased significantly between pre-PVE and short-term follow-up and between short-term and mid-term follow-up in group A. Increase in FLR volume was significantly higher at the mid-term follow-up than at the short-term follow-up in group A. The ratio of embolized to total liver volume (RETLV) on short-term follow-up was significantly higher in group A than in group B. Aspartate transaminase (AST) and alanine transaminase (ALT) were elevated on short-term follow-up, whereas at mid-term follow-up in group A, they had significantly returned to the baselines.

Conclusion

PVE resulted in continued compensatory hypertrophy of the unembolized liver during the 6-month follow-up. Compensatory hypertrophy in the unembolized liver was proportional to the ratio of embolization and to the embolized liver volume.